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Feb. 22. 2016 1 : 27PM No. 2018 P. 3 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> PROJ ECT ADDRESS <br /> tt// • <br /> t .. <br /> b'd. i2 )e ( , , 'iI. . .." <br /> /A• Q) 11.. ,.•t:44:11.- e r.::: ti ?S'-'1911— 11 <br /> Owner Mail Address City State/Zip Phone <br /> Tennant Mail Address City State/Zip Phone <br /> b . VAI CaVal l .1. r" ti, .:. ,% 1 1.:_. r� - <br /> ,� I(t l :4 ,I�.L:_h\.............___...__,1,+t�.�� e(,(;�1•_. ,7 Gr'"J �'1�7.1 z.11 � �.� - . <br /> Electrical Contractor ' Mail Address City Sl tel7_ip Phone <br /> ttrr• {•f,z�r115�r- ---• 0 I r9V/�c' <br /> State Number(required) City of Everett Business License Number(required) <br /> 12,(9. t.i\11 r �` [06 a . C)0 <br /> �1G L.V L <br /> Proposed Use of Building Contract Price of Work <br /> • <br /> f , 1 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: 1 -ak.Q(::... \: -ti_...................(,,a.1,(;;:\a..r3.;%,..:' .....L.-0.6\..1.. (�,)1/4.A"..<..r_� <br /> FEE _..,,__ _._ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 4.113, O, <br /> /hereby certify that I have read and examined this application and know the same to bo true and <br /> corroct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not, The granting of a permit does not presume to give authority to PERMI i'# <br /> violate or cancel the provisions of any other slate or local law regulating construction or the <br /> performance of construction, That I am authorized by the owner of this property to perform the E R002- 143 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC•� <br /> ,. '2./1)20'1 I C' <br /> Si T�BtiuHale <br /> trevwpoivor iom <br />